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Abstract:

In Brief:

An analysis of articles using the T92 severity grading system or derived classifications to report complications was undertaken. Key findings were used to construct a new flexible severity grading system.

Abstract:

In Brief:

A critical appraisal 5 years after introducing a new system to rank postoperative complications has shown a rapid and wide acceptance in the literature. To further support the use of this system, we documented an excellent correlation between the various grades of severity and perception by patients and health care providers, and obtained consensus among experts to rank difficult cases. The grades are sufficiently self explanatory that subjective terms such as minor and major complications should be avoided.

Abstract:

In Brief:

This randomized controlled trial was conducted to compare liver transection time and blood loss between the conventional clamp crushing method and a new surgical device (vessel sealing system). A total of 120 patients were registered, and the results indicated that the vessel sealing system is safe, but that it has no beneficial effect.

Abstract:

In Brief:

The role of lymphadenectomy in esophageal cancer surgery is controversial, and there is a lack of uniformity as to what the term means. This review proposes recommendations for standardization in terminology, and evaluates the evidence base for lymphadenectomy in the treatment of esophageal cancer.

Abstract:

In Brief:

Current management of hilar cholangiocarcinoma was reviewed. Surgical resection including major hepatic resection remains the mainstay of treatment of hilar cholangiocarcinoma. Additional evidence is needed to fully define the role of orthotopic liver transplantation. Improvements in adjuvant therapy are essential for improving long-term outcome.

Abstract:

In Brief:

Several oral anticoagulants are in late-phase clinical development for venous thromboembolism prevention in the surgical setting. Although clinical data show these agents to be effective and well tolerated, comparison with large observational registries indicates that results should be viewed with caution until they can be replicated in routine care settings across a broad spectrum of surgical patient populations. Specifically, compliance and postmarketing safety issues require clarification.

Abstract:

In Brief:

Laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy were compared in a prospective randomized trial. Both procedures markedly improved glucose homeostasis: insulin, glucagon-like peptide-1, and PYY levels increased similarly after either procedure. Our results do not support the idea that the proximal small intestine mediates the improvement in glucose homeostasis.

Abstract:

In Brief:

A prospective randomized multicenter trial was performed to clarify the efficacy of extensive intraoperative peritoneal lavage followed by intraperitoneal chemotherapy for advanced gastric cancer patients having intraperitoneal free cancer cells without overt peritoneal metastasis. The results revealed that extensive intraoperative peritoneal lavage followed by intraperitoneal chemotherapy therapy significantly improved the 5-year survival span of such patients.

Abstract:

In Brief:

We systematically review the literature to evaluate the utility of fluorodeoxiglucose positron emission tomography in the evaluation of neoadjuvant therapy response assessment in patients with esophageal cancer. The QUADAS questionnaire was used to define the quality of the selected publications.

Abstract:

In Brief:

In this report, a porcine peritoneal metastases model is described in which the first prospective, blinded, comparative study between transgastric natural orifice transluminal endoscopic surgery peritoneoscopy and diagnostic laparoscopy is performed. The results demonstrate that the transgastric natural orifice transluminal endoscopic surgery peritoneoscopy is inferior to laparoscopic peritoneoscopy for the detection of simulated metastases in the peritoneal cavity.

Abstract:

In Brief:

This study analyzed a cohort of 674 rectal cancer patients with stages I–III disease who underwent surgery between September 2005 and October 2007 at 7 National Comprehensive Cancer Network-designated specialty centers. The goal was to determine rate and predictors of sphincter-preserving surgery based on patient, tumor and treatment factors, utilizing descriptive statistics and multivariable logistic regression.

Abstract:

In Brief:

Classic dissection of the hilar structures during the hepatectomy portion of the liver transplant procedure is sometimes dangerous. In such cases, clamping of the hepatic hilar structures en mass can be an effective alternative. In this study, we describe our center's 10-year experience with this technique.

Abstract:

In Brief:

Pancreatic leak remains a major cause of postoperative morbidity in patients undergoing pancreatic resection. We sought to evaluate the incidence of and identify risk factors for the development of pancreatic leak in the largest reported single-institution series of distal pancreatectomy.

Abstract:

In Brief:

Contemporary institutional data on perioperative and long-term survival after total pancreatectomy for pancreatic adenocarcinoma are lacking. Data from the current study demonstrate that perioperative mortality following total pancreatectomy has dramatically decreased over time. In addition, long-term survival following total pancreatectomy versus pancreaticoduodenectomy was equivalent. Total pancreatectomy should be performed when oncologically appropriate.

Abstract:

In Brief:

Subcutaneous mastectomy with conservation of the nipple-areola skin can be performed in an oncologically safe manner in breast cancer patients who would usually undergo total mastectomy. We clear the retroareolar region precisely from any milk ducts and breast gland tissue. Necrosis of the mammilla is surprisingly rare.

Abstract:

In Brief:

There are at least 4 types described for the External Branch of the superior laryngeal nerve in the literature either in human or cadavers. For the identification of any nerve, the gold standard continues to be electromyography by recording the compound muscle action potentials. During routine thyroid operations, we have used this method to identify all the external branch of the superior laryngeal nerve and typed them.

Abstract:

In Brief:

Three micromorphometric parameters of positive sentinel nodes were compared. The location of the metastasis within the node (Dewar-classification) was not predictive for additional metastases. Invasion depth (Starz-classification) and diameter (Rotterdam-criteria) of the metastasis correlated best with additional nodal disease. Invasion depth best predicted survival.

Abstract:

In Brief:

This study provides a contemporary account of a resource surge response to multiple casualty incidences following explosive events managed at a US trauma hospital in Iraq. Results from this study provide a contemporary assessment of transfusion, surgical, and intensive care resource requirements following a single explosive event. Data from this experience may translate into useful guidelines for disaster emergency planners worldwide.

Abstract:

In Brief:

Poor vascular supply and impaired cell activity limit the indication of tissue substitutes in complex tissue defects. We developed a scaffold based on a new bioactive nanofiber that shows a profound activation of tissue healing. Cell-nanofiber interaction lead to in vitro and in vivo VEGF mediated angiogenesis and cell migration that clinically stimulated reepithelialization and tissue growth.

Abstract:

In Brief:

Delaying elective repair of hernias appears to increase the likelihood of emergency presentation, morbidity, and mortality. This statewide retrospective cohort study sought to determine whether lack of insurance is associated with an increased likelihood of presenting to a hospital with a complicated hernia, and whether insurance status might be associated with clinical outcomes.

Abstract:

In Brief:

We identified candidate perioperative quality indicators for elderly patients undergoing surgery through structured interviews with thought leaders and systematic reviews of the published data. A total of 91 indicators categorized into 8 domains were rated as valid. This project used a validated methodology to identify and rate process measures to achieve high quality perioperative care for elderly surgical patients.

Abstract:

In Brief:

Analysis of 14,610 surgical patients treated before and after the implementation of resident work hour restrictions demonstrated a significant decrease in mortality and provider-related complications. This is the first study among surgical patients to demonstrate a correlation between work hour restrictions and improvements in patient safety.